Naturally nutrient rich (NNR) score and the risk of colorectal cancer: a case-control study

Naeemeh Hassanpour Ardekanizadeh, Mahdi Mousavi Mele, Saeideh Mohammadi, Soheila Shekari, Mobina Zeinalabedini, Mohammad Masoumvand, Seyedeh Hayedeh Mousavi Shalmani, Seyed Ali Askarpour, Maryam Gholamalizadeh, Farhad Vahid*, Saeid Doaei*

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review


Background The association between colorectal cancer (CRC) and nutrients has been studied frequently. However, the association of nutrient density of diets with the risk of CRC has been less studied. This study aimed to investigate the association between CRC and naturally nutrient rich (NNR) score in Iranian adults. Method This case-control study included 160 patients with colorectal cancer and 320 controls aged 35–70 years in Tehran, Iran. Dietary intake was assessed using a 168-item food frequency questionnaire. The NNR score was obtained by calculating the average daily value of 14 nutrients including protein, vitamins A, C, D, E, B1, B2, B12, calcium, zinc, iron, folate, potassium and unsaturated fatty acids. Results Regarding dietary intake of the components of NNR score, the case group had a lower intake of polyunsaturated fat (15.41±4.44 vs 16.54±4.20 g/day, p=0.01), vitamin E (10.15±4.16 vs 13.1±5.33; p=0.001), vitamin B1 (2±0.86 vs 2.19±0.84 mg/day, p=0.03) and folate (516.45±96.59 vs 571.05±80.31; p=0.001) and a higher intake of oleic acid (8.21±5.46 vs 5.59±3.17 g/ day, p=0.01) compared with the control group. Colorectal cancer risk was inversely associated with the NNR score after adjusting for the confounders (OR 0.92; 95% CI 0.88 to 0.97; p=0.03). Conclusion Low NNR scores may be linked to CRC. If confirmed by future longitudinal research, this result may help prevent CRC by recommending nutrient-rich diets.

Original languageEnglish
Article numbere001242
Number of pages7
JournalBMJ Open Gastroenterology
Issue number1
Publication statusPublished - 2 Dec 2023


Dive into the research topics of 'Naturally nutrient rich (NNR) score and the risk of colorectal cancer: a case-control study'. Together they form a unique fingerprint.

Cite this